Margonato V, Fronte F, Rainero G, Merati G, Veicsteinas A
Istituto di Esercizio Fisico Salute e Attività Sportiva (IEFSAS), University of Milan, Italy.
Eura Medicophys. 2005 Jun;41(2):135-40.
Bracing is widely used to treat adolescent scoliosis. However, bracing may also affect respiratory and cardiovascular function. In this thirteen-weeks longitudinal study we evaluated the effect of brace wearing on maximal and submaximal cardiorespiratory capacity in adolescents with moderate idiopathic scoliosis.
Eight boys and 8 girls (12-18 years) with scoliosis of the thoracic spine (Cobb angle range 32 degrees - 42 degrees in boys and 32 degrees - 60 degrees in girls) were enrolled. Respiratory basal function (forced vital capacity, FVC, and forced expired volume in 1 s, FEV(1)) and cardiorespiratory adjustments to submaximal and maximal cycle ergometer exercise (heart rate, HR, pulmonary ventilation, VE, and oxygen consumption, VO(2)) were measured a week before fitting a brace, after 1 and 12 weeks of brace wearing, and a week after brace removal.
With respect to pretreatment values: a) after 1 week of brace wearing FVC and FEV(1) were significantly reduced in both genders; b) after 12 weeks of bracing the amount of oxygen consumed per heart beat was reduced during maximal and submaximal exercises in females only; c) ventilatory efficiency was unchanged in both genders in each condition; d) oxygen uptake during maximal exercise was decreased (by about 10-20%) in females only; e) after brace removal all variables tended to regress to pretreatment values.
Although data are preliminary and need to be confirmed on larger samples of patients, the brace appears to limit maximal exercise performance especially in girls, where it affects the cardiopulmonary efficiency. Thus, moderate physical exercise during brace wearing is advised to counteract respiratory, cardiovascular and muscle inefficiency due to ribcage movement limitations.
支具广泛用于治疗青少年脊柱侧弯。然而，支具也可能影响呼吸和心血管功能。在这项为期13周的纵向研究中，我们评估了佩戴支具对中度特发性脊柱侧弯青少年最大和次最大心肺功能的影响。
招募了8名男孩和8名女孩（12 - 18岁），他们患有胸椎脊柱侧弯（男孩的Cobb角范围为32度 - 42度，女孩为32度 - 60度）。在佩戴支具前一周、佩戴支具1周和12周后以及去除支具一周后，测量呼吸基础功能（用力肺活量，FVC，和1秒用力呼气量，FEV(1)）以及对次最大和最大周期测力计运动的心肺适应性（心率，HR，肺通气量，VE，和耗氧量，VO(2)）。
与治疗前值相比：a）佩戴支具1周后，男女的FVC和FEV(1)均显著降低；b）佩戴支具12周后，仅在女性的最大和次最大运动期间，每心跳消耗的氧量减少；c）在每种情况下，男女的通气效率均未改变；d）仅在女性中，最大运动期间的摄氧量降低（约10 - 20%）；e）去除支具后，所有变量均趋于回归至治疗前值。
尽管数据是初步的，需要在更大的患者样本上得到证实，但支具似乎会限制最大运动表现，尤其是在女孩中，它会影响心肺效率。因此，建议在佩戴支具期间进行适度体育锻炼，以抵消由于胸廓运动受限导致的呼吸、心血管和肌肉功能低下。
